St. John's Wort Study Launched

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Bethesda, MD -- The National Institutes of Health (NIH) is launching
the first U.S. clinical trial of St. John's wort, an herb widely used in
Europe to treat depression.

The three-year study, sponsored by NIH's Office of Alternative Medicine
(OAM), the National Institute of Mental Health (NIMH) and the Office of
Dietary Supplements (ODS), will include 336 patients with major depression
who will be randomly assigned to one of three treatment arms for an
eight-week trial. One-third of the patients will receive a uniform dose of
St. John's wort, another third will be given placebo, and the final third
will take a selective serotonin reuptake inhibitor (SSRI), a type of
antidepressant commonly prescribed for depression.

"This study will give us definitive answers about whether St. John's wort
works for clinical depression," said NIMH Director Steven E. Hyman, M.D.
"The study will be the first rigorous clinical trial of the herb that will
be large enough and long enough to fully assess whether it produces a
therapeutic effect."

"The compilation of research done thus far, although encouraging, still
leaves some unanswered questions about exactly how the herb works," said
Wayne B. Jonas, M.D., director of OAM, which is funding the study. "The
interest and collaboration among these three NIH components in this
clinical trial will provide the scientific expertise and clinical guidance
to rigorously investigate this herb's benefit or risk in the treatment of
depression."

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In Germany, where physicians routinely prescribe herbs for a variety of
medical illnesses, millions of doses of St. John's wort, known also by its
botanical name, Hypericum perforatum, are used daily. However, no
studies of long-term use have been conducted and published studies have
used several different doses. This study will use a standardized
preparation containing a
900 mg daily dose of the herb. In addition, study participants who respond
positively will be followed for another 18 weeks. The goal of the followup
is to determine if patients given St. John's wort have fewer relapses than
patients given placebo.

Depression, a brain disorder that affects more than 17 million adult
Americans each year, costs the nation up to $44 billion in treatment,
disability, and lost productivity -- a figure comparable to the cost of heart
disease. Worldwide, depression is also a leading cause of disability. The
illness, often chronic or recurrent, affects mood, thoughts, body and
behavior. Common
symptoms include sadness, loss of interests, decreased energy, disturbed
sleep and hopelessness. When severe, depression can lead to suicide.

"Depression is a serious and sometimes fatal medical illness and we must be
sure that the treatments people receive have been proven to be effective,"
said Dr. Hyman.

An overview of 23 clinical studies in Europe, published August 3, 1996, in
the British Medical Journal, found that the herb may be useful in
cases of mild to moderate depression. The NIH study will examine patients
with the moderate form of the disorder.

NIH officials said the clinical trial will be coordinated by Jonathan
Davidson, M.D., at Duke University Medical Center, which has received a
three-year contract to conduct the $4.3 million study. Patient enrollment
is expected to start next spring.

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

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